Overview
- Democrats’ three-year extension of enhanced ACA subsidies failed 51–48, with four Republicans — Susan Collins, Josh Hawley, Lisa Murkowski and Dan Sullivan — voting to advance it.
- The GOP Cassidy–Crapo alternative also failed 51–48 after Sen. Rand Paul opposed it and Sen. Steve Daines missed the vote; it would fund $1,000–$1,500 HSA deposits, expand bronze/catastrophic options and restrict funds for abortion and gender-affirming care.
- Independent analyses from KFF and others project many enrollees could see premiums roughly double on average if the enhanced credits expire, with millions at risk of losing coverage.
- The paired votes were part of the deal to end a prolonged shutdown and underscored the 60‑vote hurdle, setting up a political fight heading into the 2026 midterms.
- House leaders signal possible action, including bipartisan discharge petitions seeking short extensions, but no unified plan has emerged and time before Jan. 1 is limited; President Trump has praised the GOP bill’s concept without endorsing a specific fix.